Physicians Improve Counseling Skills While Earning MOC Credit

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Obesity has increased dramatically in recent decades, but “who wants to deal with the fallout of telling an adolescent girl that she’s overweight?” asks Brad Weselman, MD.

However, studies show that obese children are more likely than those of normal weight to grow into obese adults. Children’s Healthcare of Atlanta consulted with Dr. Weselman, Stephanie Walsh, MD, and other physicians in Atlanta in the development of a provider training program to increase physicians’ confidence and effectiveness in counseling children and their caregivers about healthy weight.

The provider training program, which is just one element of the Children’s Strong4Life movement, is designed to take two hours and focuses on strategies for promoting healthy weight management. Four healthy habits are emphasized:

Eat more fruits and vegetables

Drink more water and fewer sugar-sweetened beverages

Decrease screen time

Increase physical activity

Dr. Weselman, who is a 2014 Paul V. Miles Fellow, says that overwhelming a child with health goals isn’t very effective, so the program counsels physicians to encourage children to set just one or two goals at a wellchild visit.

“The child may agree to limit screen time to an hour a day, and eat French fries only once a week, instead of every day,” he says. “You give them goals they can reach, then the next time they come in, if they’re making progress with those goals, you help them set some more. It doesn’t have to be all or nothing.”

Physicians who complete the Strong4Life training receive a toolkit to support their counseling efforts. The toolkit includes a color-coded body mass index (BMI) chart, a Healthy Habits questionnaire for parents and tips to jump-start Strong4Life healthy habits.

A pilot study of the Strong4Life program showed after training, more physicians calculated BMI at well-child visits (86 percent before training, 97 percent after training). The greatest difference, though, was seen in physician confidence. Only 19 percent of physicians in the trial perceived themselves as effective in treating obese patients before training; nearly 56 percent perceived themselves as effective after training. Before training, about 28 percent perceived themselves as effective in motivating patients to change their habits; after training, nearly 64 percent perceived themselves as effective.